Endovascular balloon catheter

ABSTRACT

A balloon catheter is disclosed for endovascular procedures. In one embodiment, among others, the balloon catheter includes an elongated catheter body. At a distal end, the catheter body also includes an angled tip and a balloon adjacent to the angled tip. The balloon is inflatable to form an oblong shape.

BACKGROUND

Hemodialysis is a common procedure that patients undergo whenexperiencing kidney failure. Preserving vascular access is a highpriority for these patients as adequate vascular access is required forhemodialysis procedures. The use of surgically created arteriovenousfistulas and arteriovenous grafts have been advocated as a first optionin hemodialysis patients. Arteriovenous fistulas and arteriovenousgrafts are high velocity connections that are created between an arteryand a vein and are ideal for adequate hemodialysis.

BRIEF DESCRIPTION OF THE DRAWINGS

Many aspects of the present disclosure can be better understood withreference to the following drawings. The components in the drawings arenot necessarily to scale, with emphasis instead being placed uponclearly illustrating the principles of the disclosure. Moreover, in thedrawings, like reference numerals designate corresponding partsthroughout the several views.

FIG. 1 is a perspective view of an exemplary balloon catheter, accordingto one embodiment described herein.

FIG. 2A is a first cross-sectional view of the balloon catheter fromFIG. 1 in which the balloon is in an inflated state and a portion of anouter surface of the catheter body is omitted, according to oneembodiment described herein.

FIG. 2B is a second cross-sectional view of the balloon catheter fromFIG. 1 in which the balloon is in a deflated state, according to oneembodiment described herein.

FIG. 2C is a third cross-sectional view of an inner tube of the ballooncatheter from FIG. 1, according to one embodiment described herein.

FIG. 3 is a view of the balloon catheter within a blood vessel in whichthe balloon is inflated, according to one embodiment described herein.

FIG. 4A is a view of the balloon catheter from FIG. 1 within a bloodvessel, according to one embodiment described herein.

FIG. 4B is a view of a balloon catheter with a first alternative balloonshape, according to one embodiment described herein.

FIG. 4C is a view of a balloon catheter with a second alternativeballoon shape, according to one embodiment described herein.

FIGS. 5A and 5B illustrate a side view of the balloon catheter insertedwithin a vein in an anterograde direction, according to one embodimentdescribed herein.

FIG. 5C illustrates a side view of the balloon catheter inserted withina vein in a retrograde direction toward an arterial end, according toone embodiment described herein.

FIG. 6 illustrates an alternative balloon catheter with a two layerballoon, according to one embodiment described herein.

FIG. 7 is a flowchart illustrating a process for using the ballooncatheter in FIG. 1, according to various embodiments of the presentdisclosure.

DETAILED DESCRIPTION

The present application relates to an endovascular balloon catheter thatenables changing the direction of an angled tip of the balloon catheterwithin a lumen, such as a blood vessel. In many cases, endovascularprocedures need multiple vascular access points in a patient in order toaccomplish a procedural objective. For example, hemodialysis is a commonmedical procedure in which preserving vascular access is a high priorityin order to continue performing hemodialysis procedures in the future.The use of surgically created arteriovenous fistulas (AVFs) andarteriovenous grafts (AVGs) has been advocated as the first option inhemodialysis patients. AVFs and AVGs are high velocity connections thatare created between an artery and a vein and are ideal for adequatehemodialysis.

However, these vascular accesses have limited durability with a tendencyto narrow and ultimately occlude (e.g., thrombose) over time. In somecases, it is estimated that AVG thrombosis occurs approximately 0.5-2.0times per year and AVF thrombosis occurs 0.1-0.5 times a year. It isalso believed that thrombosis accounts for approximately 65-85% AVF/AVGloss. To minimize the loss of AVFs and AVGs, several techniques havebeen developed to reopen (e.g., declot) these vascular circuits.Illustrative examples of such techniques include the use of thrombindissolving medicine (e.g., tissue plasminogen activator), mechanicalthrombectomy, and/or balloon thrombectomy.

Despite the different methods for clot removal, all of these methodstypically require obtaining two separate non-overlapping vascular accesssites within a blood vessel directed in opposite directions. Forinstance, there is a first vascular access site in a blood vessel foraccessing an anterograde direction (venous outflow) and a secondvascular access site for accessing a retrograde direction (arterialinflow). The operator can only treat the blood vessel in front of thevascular access site. During a traditional declot procedure,thrombolysis and thrombectomy are first performed from the outflowsheath to clear a thrombus (e.g., blockages) from the venous outflowusing a first vascular access site. Once the venous side of the accessis cleared, thrombolysis and thrombectomy is then performed from theinflow or retrograde sheath directed toward the arterial inflow using asecond vascular access site. Once both the inflow and outflow arecleared of the thrombus, attention is then turned to identify and treatresidual stenoses, before sheaths are removed and hemostasis is obtainedat both access sites.

Existing catheters can only push or pull a clot out in the direction ofits original access and as a result, two access sites are needed inorder to access both directions. When two access sites are involved,additional surgical equipment may be needed to perform a declotprocedure (e.g., two sheaths, angled catheter, a straight thrombectomyballoon).

The various embodiments of the present disclosure relate to an improvedendovascular catheter with an angled tip and an inflatable oblong-shapedballoon. The embodiments of the present disclosure enable forendovascular thrombectomy procedures to be performed more safely due tothe need for a single access site, more efficiently, and with lesssurgical equipment. For example, the embodiments can reduce the need forone-third of the steps typically performed during a declot procedurebecause the embodiments can reorient the balloon catheter in both ananterograde direction and a retrograde direction from a single vascularaccess site.

With reference to FIG. 1, shown is a perspective view of a ballooncatheter 100 connected to a catheter hub 103, in which the catheter hub103 is connected to a syringe 106. The balloon catheter 100 comprises acatheter body 109, a balloon 112, and angled tip 115.

The catheter body 109 has an elongated cylindrical shape between a firstend 118 and a second end 121. The catheter body 109 can be connected tothe catheter hub 103 on the first end 118. At the second end 121, thecatheter body 109 can include the balloon 112 adjacent to the angled tip115. The catheter hub 103 can comprise a first port that connects to thecatheter body 109 at the first end 118. The catheter hub 103 can alsocomprise a second port that connects to the syringe 106 and a third portfor inserting a guide wire (FIGS. 4A, 4B, and 4C).

The catheter body 109 can have a diameter in a range between 1.25 mm and2.25 mm. In some embodiments, the catheter body 109 has a diameter of1.667 mm (e.g., 5 French). The balloon 112 can be used to push, pull,and/or remove blockages within a lumen. As one skilled in the art canappreciate, the balloon 112 can be used for other endovascular actions.The balloon 112 can comprise a compliant balloon, a non-compliantballoon, and other suitable balloon materials. When inflated, theballoon 112 can be configured to form an oblong shape, where a length ofthe balloon 112 is longer than its width. In some non-limiting examples,an oblong shape may comprise a donut shape, an oval, a rectangle, andother suitable oblong shapes. When deflated, an outer surface of theballoon 112 can be in alignment with an outer surface of the catheterbody 109.

When inflated, the shape of the balloon 112 can used to anchor theballoon 112 against an inner surface of a blood vessel wall surroundinga vessel access point. Particularly, the shape and dimensions of theballoon 112 provide sufficient surface area such that the balloon 112can be used as an anchor to rotate the angled tip 115 within a vessel.When the balloon 112 is positioned adjacent to the vessel access point,the surface area of the balloon 112 prevents that balloon from movingout of the vessel access point.

The balloon catheter 100 also comprises an angled tip 115 that can beadjacent to the balloon 112, e.g., integrally formed with and extendingfrom the bottom surface 212 of the balloon 112 and including asubstantially straight portion 115 b extending from a curved region 115a parallel to a tip axis 116 of the angled tip 115, as shown in FIG. 2A.In some embodiments, the curve of the angled tip 115 can begin adjacentto a distal end of the balloon 112, e.g., immediately adjacent thebottom surface 212, as also shown in FIG. 2A. In other embodiments,portions of the balloon 112 can extend along areas of the angled tip115. In this non-limiting example, during an inflated state, portions ofthe balloon 112 may surround a portion of the angled tip 115. Thearrangement of the balloon 112 and the angled tip 115 provide a meansfor the end of the angled tip 115 of the balloon catheter 100 to berotated from a first direction to a second direction within a lumenwhile the balloon 112 is inflated. The balloon 112 may be inflated witha gas (e.g., air), a liquid, or by other suitable means as can beappreciated by one skilled in the art.

With reference to FIG. 2A, shown is a first cross-sectional view of theballoon 112 and angled tip 115 from FIG. 1, particularly with theballoon 112 inflated between a first balloon end 201 and a secondballoon end 202. As shown in FIG. 2A, the catheter body 109 comprises aninner tube 203 with multiple openings 206. A gas or liquid from thesyringe 106 (FIG. 1) can travel through the openings 206 to inflate theballoon 112. The number of openings 206, the shape of the openings 206,and the opening locations can vary.

As previously discussed, the catheter body 109 may have a diameter,referenced by “D1” in FIG. 2A. In some embodiments, the diameter D1 maybe in a range between 1.25 mm and 2.25 mm. When inflated, the balloon112 comprises a top surface 209 and a bottom surface 212. The balloon112 may also have a length, referenced by “L,” in a range between 0.25mm and 7.0 mm. In some examples, the length “L” of the balloon 112 in aninflated state is about 6 mm. In some non-limiting examples, the length“L” of the balloon 112 and the diameter “D1” of the catheter body 109may have a ratio(D1/L) of in a range about 0.20 to 0.3. In someexamples, the ratio is about 0.2666. Additionally, the balloon 112 mayhave a width, referenced by “W,” in a range between 0.25 mm and 6.25 mmin an inflated state. In some non-limiting examples, the width “W” isabout 2 mm. The distance, referenced by “D2,” from the top surface 209of the balloon 112 to an end 215 of the angled tip 115 can be less than6.5 mmm, and in some examples, the distance “D2” may be in a rangebetween 4.5 mm to 5.5 mm. In other examples, the distance “D2” may be ina range between 0.25 to 6.5 mm. Further, a distance, referenced by “D3,”from the bottom surface 212 of the balloon 112 to the end 215 of theangled tip 115 may be in a range between 1.5 mm and 3.5 mm. In someexamples, the distance “D3” may be about 2.5 mm.

Further, the angled tip 115 may be configured at an angle between alongitudinal axis 101 of the catheter body 109 and the tip axis 116,referenced by “A” in FIG. 2A, between the catheter body 109 and anextend member of the angled tip 115. The angle “A” can vary in a rangefrom 125 degrees to 175 degrees. In some examples, the angle “A” isabout 150 degrees. In some non-limiting examples, as illustrated in FIG.2A, the end 215 of the angled tip 115 does not extend pass the firstballoon end 201 of the balloon 112 in its inflated state. In someembodiments, the end 215 of the angled tip 115 is alignment with thefirst balloon end 201

Moving to FIG. 2B, shown is a cross-sectional view of the second end 121of the balloon catheter 100, particularly a cross-sectional view of theballoon 112 and the angled tip 115 when the balloon 112 is in a deflatedstate. In FIG. 2B, the balloon channels (FIG. 2C) are omitted. In someembodiments, along the width “W” of the balloon 112, the composition ofthe balloon materials may vary. For example, the outer regions 218 a,balong the width “W” of the balloon 112 may be comprised of balloonmaterials that are less elastic than a center region 221 of the width“W” of the balloon 112. In another non-limiting example, the outerregions 218 a,b may be comprised of non-compliant balloon materials, andthe center region 221 may be comprised of compliant balloon materials.In this non-limiting example, the outer regions 218 a,b can expand orstretch to predefined dimensions. Since the center region 221 iscomprised of compliant balloon materials, it can expand further than thepredefined dimensions. The different compositions of balloon materialsalong the width “W” can facilitate the balloon 112 conforming to anelongated length “L” that is longer than the width “W.”

With reference to FIG. 2C, shown is an enlarged cross-sectional view ofthe second end 121 of the balloon catheter 100 from FIG. 2A, in which aninterior of the inner tube 203 of the catheter body 109 is exposed. InFIG. 2C, shown are the multiple openings 206 of the inner tube 203.Additionally, in this embodiment, the inner tube 203 is illustrated witha first balloon channel 224 a and a second balloon channel 224 b(collectively balloon channels 224). The balloon channels 224 areconnected to the second port (FIG. 1) of the catheter hub 103 (FIG. 1),which is connected to the syringe 106. Thus, the gas or liquid from thesyringe 106 (FIG. 1) can travel from the syringe 106 through thecatheter hub 103 and into the one or more balloon channels 224. At thesecond end 121 of the catheter body 109, the gas or liquid travels fromthe balloon channels 224 through multiple openings 206 into the interiorof the balloon 112, which causes the balloon 112 to inflate.

Further, the balloon catheter 100 comprises a guidewire channel 227 thatenables a guide wire to travel from the third port of the catheter hub103 through the catheter body 109 and through the inner tube 203. Fromthe guidewire channel 227, the guide wire can pass through to the end215 of the angled tip 115.

Next, with reference to FIG. 3, shown is the balloon catheter 100 withina lumen 303 (e.g., a blood vessel, a graft, etc.) in which the balloon112 is inflated. As shown in the FIG. 3, the length “L” (FIG. 2A) of theballoon 112 is positioned perpendicular to a directional flow of thelumen 303. In other scenarios, the balloon 112 can be positionedparallel to a directional flow of the lumen 303 (FIG. 4A and FIG. 5A).In FIG. 3, the balloon 112 is positioned such that the first balloon end201 and the second balloon end 202 of the balloon 112 are in contactwith the interior surface of the lumen 303, as indicated in regions 307a,b. Since the distance “D2” (FIG. 2A) of the balloon catheter 100 iscompact with respect to a diameter of the lumen 303, the angled tip 115of the balloon catheter 100 can be rotated while the balloon 112 isinflated. Blood vessels, lumens, and other suitable blood transportcarriers may have a diameter in a range between 5.75 mm and 6.25 mm. Thetop surface 209 (FIG. 2A) of the balloon 112 can be positioned adjacentor substantially near a top of the lumen 303 surrounding an access point310 of the lumen 303, and then, the angled tip 115 can be rotated withinthe lumen 303.

Turning to FIG. 4A, shown is side view of the balloon catheter 100within a blood vessel 401. In FIG. 4A, the top surface 209 of theballoon 112 can be positioned adjacent to the inner surface of the bloodvessel surrounding a vascular access point 405. A sheath 404 ispositioned at the vascular access point 405. The length “L” of theballoon 112 prevents the balloon 112 from passing through the vascularaccess point 405 while the balloon 112 is inflated. Typically, thevascular access point 405 has a diameter around 1.8 mm to 2.2 mm. Thelength “L” of the balloon 112 in an inflated state is sufficiently longenough to prevent the balloon 112 from being pulled out of the vascularaccess point 405 while the balloon 112 is inflated. Additionally, thecompact dimensions of the balloon catheter 100 at the second end 121provides enough spacing for the angled tip 115 to rotate from a firstdirection to a second direction within blood vessel 401. FIG. 4A alsoillustrates a guide wire 409 advanced from the angled tip 115.

Moving to FIG. 4B, shown is a side view of the balloon catheter 100 witha tapered balloon 412. The tapered balloon 412 comprises a top surface415 that can have a sufficient surface area to prevent the taperedballoon 412 from passing through the vascular access point 405. Thetapered balloon 412 also includes a bottom portion that has a smallerlength than the top surface 415. Further, FIG. 4C illustrates a sideview of the balloon catheter 100 with an alternative balloon 421.

FIGS. 5A through 5C illustrate side views of different stages of theballoon catheter 100 being used in at least a portion of a thrombectomyprocedure. FIGS. 5A and 5B illustrate a side view of the ballooncatheter 100 inserted within a vein 503 in an anterograde direction.FIGS. 5A and 5B illustrate the vein 503 connected to an artery 506. InFIG. 5A, the balloon 112 has been inflated at the vascular access point405. FIG. 5A also illustrates that a guide wire 409 can be advanced inthe anterograde direction in order to facilitate clearing blockage 509a.

Additionally, FIG. 5B illustrates that the balloon 112 has been advancewithin the vein 503 in the anterograde direction. FIG. 5B alsoillustrates blockage 509 a (e.g., clots) can be cleared by using theballoon 112. Particularly, the balloon 112 and the catheter body 109have been manipulated such that the balloon 112 has been rotated about90 degrees from its previous orientation in FIG. 5A. In this presentconfiguration, the balloon 112 can be used to push blockage 509 afurther in the anterograde direction. Pushing the blockage 509 a withballoon 112 can be effective in breaking down the blockage 509 a inorder to clear out the blood flow in the anterograde direction. Afterthe anterograde direction (e.g., venous outflow) has been cleared, theballoon 112 can be pulled back to its position at the vascular accesssite 405, as illustrated in FIG. 5A.

At the vascular access point 405, the elongated shape of the balloon 112has enough surface area on the top surface 209 (FIG. 2A) to providevessel wall apposition, which prevents the balloon 112 from being pulledout the vein 503 at the vascular access point 405. Further, the guidewire 409 can be pulled back toward the catheter hub 103, such that theend of the guide wire is near the angled tip 115, within the angled tip115, and within the catheter body 109. With the balloon 112 inflated,the balloon 112 and the angled tip 115 can be rotated within the vesselfrom the anterograde direction to a retrograde direction toward anarterial end. In some examples, the balloon 112 is rotated about 180degrees about the vascular access point 405.

FIG. 5C illustrates a side view of the balloon catheter 100 oriented inthe retrograde direction toward an arterial end after the balloon 112has been rotated. FIG. 5C illustrates that blockage 509 a has beencleared. At this point, in some scenarios, the guide wire 409 can beadvanced. Then, the balloon 112 can be deflated, and the catheter body109 is advanced over the guide wire 409. The sheath 404 can be advancedto further stabilize access. In this embodiment, once the catheter body109 is advanced into the artery 506, the balloon 112 can be inflatedagain and used to complete a thrombectomy procedure by clearing theinflow of blockages 509 b and any others.

Next, FIG. 6 illustrates an alternative balloon catheter 600 with a twolayer balloon 604. The two layer balloon 604 comprises an inner balloonlayer 607 and an outer balloon layer 610. The outer balloon layer 610can be attached to the inner balloon layer 607. In some examples, theinner balloon layer 607 and the outer balloon layer 610 may include acompliant balloon, a non-compliant balloon, and other suitable balloonmaterials.

In the non-limiting example of FIG. 6, the inner balloon 607 is acompliant balloon, and the outer layer 610 is comprised of non-compliantmaterial. The inner balloon layer 607 can have varied shapes wheninflated. The outer balloon layer 610 can be configured to restrict theshape of the inner balloon layer 607 as the inner balloon layer isinflated. In an inflated state, the outer balloon layer 610 can form arestrictive cylindrical shape that surrounds the inner balloon layer607. The outer balloon layer 610 can permit the inner balloon layer 607to expand to a predefined width “PW,” and further expansion of the innerballoon layer 607 is limited to extend its length “L2”. Accordingly,from a deflated state, the inner balloon layer 607 expands its widthuntil it reaches a restrictive width “PW” of the outer balloon layer610. Once the inner balloon layer 607 reaches the restrictive width“PW,” the inner balloon layer 607 can further expand along its length“L2.” In some embodiments, the outer balloon layer 610 can form a sleevethat surrounds the inner balloon 607. In an inflated state, the outerballoon layer 610 has a length “L3” that is smaller than the length “L2”of the inner balloon layer 607 in an inflated state.

Referring next to FIG. 7, shown is a flowchart of a series of steps forusing the various embodiments of the present disclosure. It isunderstood that the flowchart of FIG. 7 provides merely one example,among others, that may be employed to use the various embodiments of thepresent disclosure.

Beginning with box 701, a process 700 may include inserting a distal endof a balloon catheter through an access site 405 of a blood vessel. Thedistal end of the balloon catheter 100 may comprises an angled tip 115and a balloon 112 adjacent to the angled tip 115. While the distal endis being inserted, the balloon 112 may be in a deflated state.

In box 704, the process 700 may include inflating, within the bloodvessel, the balloon 112 of the balloon catheter 100 at an access site ofa blood vessel. The balloon 112 can form an oblong shape in an inflatedstate, and the angled tip 115 is positioned in an anterograde directionof the blood vessel. In this orientation, the guidewire 409 and/or theballoon 112 can be used to clear blockages 509 in the anterogradedirection. In some scenarios, the balloon 112 can be manipulated indifferent orientations within the blood vessel to push blockages 509.

In box 707, the process 700 may include positioning a top surface of theballoon 112 adjacent to a surrounding area of the access site within theblood vessel. While in an inflated state, the oblong shape of theballoon 112 can provide sufficient surface area to create enough vesselwall opposition in order to prevent the balloon 112 from being pulledout of the access site 405.

In box 710, the process 700 may include rotating the balloon 112, in aninflated state, at the surrounding area of the access site. As a result,the angled tip 115 can be repositioned from the anterograde direction toa retrograde direction toward an arterial end. In some examples, theangled tip 115 can be rotated about 180 degrees with respect to theaccess site 405. Then, the process 700 proceeds to the end.

Disjunctive language such as the phrase “at least one of X, Y, or Z,”unless specifically stated otherwise, is otherwise understood with thecontext as used in general to present that an item, term, etc., may beeither X, Y, or Z, or any combination thereof (e.g., X, Y, and/or Z).Thus, such disjunctive language is not generally intended to, and shouldnot, imply that certain embodiments require at least one of X, at leastone of Y, or at least one of Z to each be present.

It should be emphasized that the above-described embodiments of thepresent disclosure are merely possible examples of implementations setforth for a clear understanding of the principles of the disclosure.Many variations and modifications may be made to the above-describedembodiment(s) without departing substantially from the spirit andprinciples of the disclosure. All such modifications and variations areintended to be included herein within the scope of this disclosure andprotected by the following claims.

Therefore, the following is claimed:
 1. A balloon catheter, comprising:a catheter body having an elongated cylindrical shape and comprising afirst end, a second end, and a longitudinal axis aligned between thefirst and second ends; a balloon comprising a top surface coupled to thesecond end, a bottom surface spaced distally from the top surface,wherein the balloon is inflatable to an oblong shape having a lengthperpendicular to the longitudinal axis that is greater than its widthalong the longitudinal axis; and an angled tip fixed to and extendingfrom the bottom surface along a tip axis that extends from the bottomsurface at an angle relative to the longitudinal axis, wherein, wheninflated, a distance from the top surface of the balloon to an end ofthe angled tip is in a range of 0.5 mm to 6 mm.
 2. The balloon catheterof claim 1, wherein the oblong shape comprises a donut-shape or an ovalshape.
 3. The balloon catheter of claim 1, wherein, when inflated, thewidth of the balloon is in a range of 0.5 mm to 6 mm.
 4. The ballooncatheter of claim 1, wherein the balloon comprises at least one of acompliant balloon or a non-compliant balloon.
 5. The balloon catheter ofclaim 1, wherein the angle of the angled tip comprises an angle in arange of 135 degrees to 165 degrees with respect to the longitudinalaxis of the catheter body.
 6. The balloon catheter of claim 1, whereinwhen the balloon is inflated, the angled tip can be changed from a firstdirection to a second direction while in a lumen.
 7. The ballooncatheter of claim 1, wherein the balloon comprises an inner balloonlayer and an outer balloon layer that attaches to the inner balloonlayer, wherein the outer balloon layer restricts the width of theballoon during an inflated state.
 8. The balloon catheter of claim 7,wherein the length comprises a first length, and when inflated, theouter balloon layer has a second length that is less than the firstlength of inner balloon layer.
 9. The balloon catheter of claim 7,wherein the inner balloon layer comprises a compliant balloon and theouter balloon layer comprises a non-compliant balloon material.
 10. Theballoon catheter of claim 1, wherein the balloon comprises two outerregions along the width and a central region along the width, whereinthe two outer regions have a first balloon material composition and thecentral region has a second balloon material composition.
 11. Theballoon catheter of claim 1, wherein the balloon comprises a taperedregion from the top surface to a bottom region of the balloon.
 12. Theballoon catheter of claim 1, wherein a distance from the bottom surfaceof the balloon to an end of the angled tip is in a range from 1.75 mm to3.25 mm.
 13. The balloon catheter of claim 1, wherein a curved surfaceof the angled tip begins adjacent to the bottom surface of the balloon.14. The balloon catheter of claim 1, wherein when inflated the length ofthe balloon is in a range between 0.5 mm-6.25 mm.
 15. A ballooncatheter, comprising: a catheter body comprising a first end, a secondend, and a longitudinal axis aligned between the first and second ends;a balloon comprising a top surface coupled to the second end and abottom surface spaced distally from the second end, wherein the balloonis inflatable to an oblong shape having a length perpendicular to thelongitudinal axis that is greater than its width along the longitudinalaxis; and an angled tip fixed to and extending from the bottom surfacealong a tip axis that extends at an obtuse angle relative to thelongitudinal axis, the angled tip comprising a curved region beginningimmediately at the bottom surface and a substantially straight portionextending from the curved region parallel to the tip axis, wherein adistance from the top surface to an end of the angled tip parallel tothe longitudinal axis is less than 6.5 mm.
 16. The balloon catheter ofclaim 15, wherein the substantially straight portion of the angled tipterminates at a rounded end.
 17. The balloon catheter of claim 15,wherein, when the balloon is in an inflated state the balloon definesfirst and second side ends defining the length of the balloon, an end ofthe angled tip does not extend laterally past the first side end in theinflated state.
 18. A balloon catheter, comprising: a catheter bodycomprising a first end, a second end, and a longitudinal axis alignedbetween the first and second ends; a balloon comprising a top surfacecoupled to the second end and a bottom surface spaced distally from thesecond end, wherein the balloon is inflatable to an oblong shape havinga length perpendicular to the longitudinal axis that is greater than itswidth along the longitudinal axis; and an angled tip integrally formedwith the balloon and extending from the bottom surface along a tip axisthat extends at an obtuse angle relative to the longitudinal axis, theangled tip comprising a curved region beginning immediately at thebottom surface, a substantially straight portion extending from thecurved region parallel to the tip axis, and terminating in a roundedend, wherein a distance from the top surface to the rounded end parallelto the longitudinal axis is less than 6.5 mm.